Improving Diagnosis of Dyslexia through Standardized testing or Genetics?

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Standardized testing, our first idea moving forward from this stage, will act as a filter across the board to help screen students across the country for flags that may/may not lead to dyslexia. Our idea is having a standardized test with reading and comprehension tasks, as well as other cognitive tasks. We have to decide on what type of tasks the test will have in the future. The point of this testing is that it will narrow down who’s at risk and who isn’t while allowing us to be more effective in detecting dyslexia early on. At the moment, standardized testing is different in every state; private schools most likely do not administer standardized tests, and we would have to determine how to bring a comprehensive screening test to thousands of students across the country. Of course, it is not a perfect solution, but our goal is to improve diagnosis. Further, it shouldn’t be difficult to implement this type of testing in schools, having teachers or nurses administer it since they do so with plenty of other exams.

Genetic testing, our more biological solution, would bring a great solution to our problem. Dyslexia is inherited in some cases and certain genes have been found in those predisposed to having dyslexia. Instead of imaging, we could trace the genetic markers for dyslexia and be able to use them effectively for early diagnosis. Our problem with this is families being limited financially for genetic testing; moreover, the scale of research has been very limited thus far. We thought this is a better solution than imaging, however, because it is more concrete. Some genes have already been targeted and screening can be done on those genes. Imaging is prone to more inaccuracies and heterogeneity.

Feedback on Solution 1: Standardized testing

For standardized testing the following “yes ands..” and “yes, buts…” were most important and helpful in revising our solutions.

Yes and…

“You should consider looking at neuropsychological examinations. They have a lot of different tasks that test different skills. These test results can be used by a psychologist/psychiatrist to diagnose certain disorders. The results can also be used as evidence that a child requires special accommodations on tests.”

This is a good idea! Neuropsychological exams test all sorts of cognitive domains. In creating one standardized test to be used across the globe, these cognitive domains should be looked at. The test should also be consistent and our group will look into neuropsychological testing as we explore which tasks to put on the test and what to test for. Our goal is to have teachers and nurses to administer the test, however, because this is more feasible and easier to implement than children going to psychologists/psychiatrists.

If you create a standardized test, be sure to add control tasks!

Control tasks are very important to ensure that the child is truly dyslexic and not just having a bad testing day. This is important to ensure that there aren’t any situational factors playing a role in the performance of the child when they take the test. Some control tasks could be questions looking into other types of cognitive performance such as including some math questions or oral comprehension tasks. For example, s telling the student to do a certain action and seeing if they follow along correctly could be a control task. Thus, we will definitely include this in our solution.

“It will allow teachers/parents to be aware that the kid, may have trouble learning/reading.”

This feedback really makes us believe that standardized testing could be a great idea and impact the lives of dyslexic children in a good way. Testing across the most important years of a child’s life, can increase diagnosis, so that teachers and parents are aware of the learning disorder. This way, both teachers and parents will be able to take action to help the child best succeed.

Yes, but…

“How can you differentiate different learning disabilities from dyslexia”

This is a really important concern to consider. Other learning disabilities or disorders. There are several related learning disabilities to dyslexia such as ADD/ADHD, autism, central auditory processing disorder (where people have difficulty comprehending words they hear), dyscalculia, dysgraphia, etc. Regarding this solution, we would have to create a test that will distinguish between different learning disorders. However, this can be difficult because of the diversity of performance from children and the relatability between dyslexia and other disorders. When thinking of tasks and questions, we would have to be careful that we choose ones to target dyslexia accurately.

“How to prevent kids from hacking the test, like memorizing certain letter shapes or something”

People often do try hacking tests because of fear of discovering that they have a disorder or a problem. In forming a standardized test, it is important to ensure that the questions aren’t predictable and that they can beat tricks that people try to do to perform better on the exam.

“Where would the cutoff be for dyslexic/not dyslexic”

This is something really important to consider. We don’t want testing to give false positives or false negatives. A false positive can completely change the self-perception of the child and how as their academic training. False negatives are also bad, because, ideally, no child will be left behind. Finding that “sweet spot,” the threshold between being dyslexic and not will be tough, as testing performance is quite variable. We would have to think of questions that will prevent this from happening to the best of our abilities.

Feedback on Solution 2: Genetic testing

Yes and…

There are people from different backgrounds/ethnicities. Maybe you could find trends? Maybe some are more prone to have dyslexia?

Reading disorder rates show no racial differences. It’s possible, but leads to the problem of environmental factors versus genetics. This would probably lead the solution into studying different regions and cultures, rather than considering race in looking at genetics.

Genetic testing could be used for predictive purposes.

This would be good to treat dyslexia early on, but it is timely and expensive. Family studies show that a reading disorder is heritable, is found in clusters in families, and probably reflects autosomal dominant transmission. This would help narrow down the field in terms of who is at risk, and who to focus this treatment on, but it is not as widespread.

Genetics could be used in choosing specialized treatment.

Specialized treatment, again, is timely, limited, and expensive. Genetic testing would limit the scope of our solution and we want to be able to help as many people as possible. Knowing the specific dyslexia gene may seem out of reach since dyslexia and language disorders manifest themselves in many different ways.

Yes, but…

Is there research into a potential genetic marker for dyslexia

Very true. It may be too out of reach right now to create groundbreaking research on thee genetic manifestations of dyslexia or refer to existing research on it.

What is the % that dyslexia is carried in the gene

Finding the gene might pose one problem, but then we must see how reliable that data and gene is for representing dyslexia. Finding that percentage further complicates the solution.

Does the environment contribute to the genetic factors as well

This is true and leads further complication of this solution since development is generally 50% nature and 50% nurture. Environmental factors might have a bigger pull in this due to the nature of language and cultures.

After reading the feedback we received from our classmates, we decided that it would be best if we moved forward with our first solution. Regarding solution 1, there is a lot of issues and difficulties with targeting dyslexia simply with a standardized test. Rather than causing us to do away with the solution, it just opened our eyes to more information to consider in establishing such a test. We still think it would be a good idea to have a standardized test in schools for dyslexia because it is feasible, efficient, and may improve diagnosis. This will also be helpful, especially since some people never go to be tested due to time, money, or just not knowing that there may be a problem. It would have to be a test that covers all cognitive domains with questions that are effective in distinguishing dyslexia from other learning disorders, as well as preventing false positives and negatives as much as possible. The tasks and questions should also be able to minimize high scores due to tricks, memorization, or cheating. Also, it must have control tasks to ascertain that situational factors don’t play a role in performance. Ultimately, we believe testing would be a great idea because it can raise awareness, and catching it early on can help teachers and parents take action to help the child succeed. On the other hand, the genetic testing idea posed more issues the more we looked into it. For example, there isn’t a lot of research on the genetics behind dyslexia, so moving forward with this idea would require much more experimental and less concrete data. Additionally, it has been proposed that dyslexia has both genetic and environmental factors, so the genetic test method would fail to incorporate the idea that the environment affects how dyslexia presents as well.